ADL General Collection Information: Difference between revisions

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'''Activities of Daily Living''' (ADL) ~~refers~~ to daily self-care activities.

The '''Activities of Daily Living''' (ADL) assesses a patient's capability to perform six daily self-care activities.

== Collection Instructions ==

The ADL ~~assesses~~ a patient~~'s capability~~ to perform ~~a certain activity~~. ~~Enter the status~~ into the ADL ~~dropdown boxes in~~ the ADL ~~tab in~~ [[~~CCMDB.accdb~~]].

* The ADL assessment should reflect the amount of assistance a patient requires to perform the six activities. It takes into consideration acute medical issues that resulted in admission to the hospital.

* Using your best judgment based on age, diagnosis, pre hospital admission ADL, and [[#Where to get data]] below, select the option that best reflects their ADL status

* For ostomy care see [[ADL Toiletting]] and [[ADL Continence]]

* For use of mechanical aids see [[ADL Transfering]]

=== Timeframe ===

An ADL assessment ~~is usually done within 24 hours of admission~~ (done by allied health or nurses).

The ADL assessment (done by allied health or nurses) we utilize is the patient's state of activity on first [[Service tmp entry]]. When possible, use an ADL assessment done within 24 hours after the admission to the ward

~~The ADL assessment~~ we utilize is the patient's state of activity on admission (~~not at home prior to admission~~)~~. It takes into consideration acute medical issues~~ that ~~resulted in admission~~ to the ~~hospital~~.

{{~~Discuss~~| ~~To clarify this~~ point, ~~when does~~ the ~~24 hour timeframe begin, from acceptance date/~~time ~~or arrival date/time for patients admitted from ER?~~ }}

=== Low functioning ADL due to condition that is expected to be temporary ===

If a patient is admitted with a diagnosis that is expected to improve to the point of higher functioning ADLs (and they possibly have improved already by the time collection happens), code the ADLs that are expected to be the long-term state.

{{Ex|

A patient is admitted with [[Diabetic ketoacidosis (DKA)]] and is expected to improve with treatment to the point where they can manage their activities of daily living (ADLs) independently. Code the ADLs based on their anticipated long-term state of independent functioning, even if they are still experiencing limitations at the time of data collection.

}}

=== Directed Restrictions ===

Directed restrictions on a patient's activities should not be assessed as requiring assistance. ~~For example,~~ if a pt is on bedrest ~~restrictions, it does not mean that they are unable physically to get out of bed~~. If the patient would be able to perform the activity if allowed then they are to be assessed accordingly.

Directed restrictions on a patient's activities should not be assessed as requiring assistance. Code these based on what the patient would actually be capable of doing if they were permitted.

{{Ex|

A patient comes in with a stroke. They can mobilize independently and go to the washroom. The patient is then ordered to be on bedrest after a procedure. If the patient would be able to perform the activity if allowed then they are to be assessed accordingly. So in this case they would would be coded as '''unassisted'''.

}}

=== Where to get data ===

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* Integrated progress notes

* Risk assessment for falls form (if used)

== Data Entry Instructions ==

For every Medicine profile, enter the status into the ADL dropdown boxes in the [[Patient Viewer Tab ADL]] in [[CCMDB.accdb]].

=== Specific Activities collected ===

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* [[ADL Continence]]

* [[ADL Feeding]]

~~== Scoring ==~~

~~The field is driven by [[S_ADLOptions table]].~~

~~Performance of each of the activities is evaluated as unassisted (0 points), minor assistance (3 points), or major assistance (6 points).~~

~~'''Total ADL Score''' is the sum of points of all the six activities.~~

~~ADL is also part of the [[ALERT Scale]].~~

== Data Use ==

* [[~~ALERT Scale Calculation~~]]

* [[ADL Score]]

* ~~Reported quarterly~~

* [[ALERT Scale]]

** Average

** Frequencies by Categories (e.g. 1-6, 7-12, 13-18, 19-24, 25-30, 31-36)

~~=== in CCMDB.accdb ===~~

~~In CCMDB the ADLs are stored as their full words rather than scores, e.g. "ADL_Bathing" might have a value of "unassisted". The values are entered via dropdown list, which is driven by the~~ [[~~S_ADLOptions table~~]]~~. In that table there is a column "sorter" with numbers used to change the order the values appear in the dropdown list. The column is '''not''' a score and not used for anything beyond sorting.~~

== References/Background ==

The evaluation tool used for all Medicine patients is the Katz ADL.

* S Katz et al. Studies of illness in the aged: the index of ADL. American Medical Association, 1963.

* S Katz, SD Downs, HR Cash, RC Grotz. Index of daily living. ''The Gerontologist'' 1:20-301.

@@ Line 1: / Line 1: @@
-'''Activities of Daily Living''' (ADL) refers to daily self-care activities.
+The '''Activities of Daily Living''' (ADL) assesses a patient's capability to perform six daily self-care activities.
 == Collection Instructions ==
-The ADL assesses a patient's capability to perform a certain activity. Enter the status into the ADL dropdown boxes in the ADL tab in [[CCMDB.accdb]].
+* The ADL assessment should reflect the amount of assistance a patient requires to perform the six activities. It takes into consideration acute medical issues that resulted in admission to the hospital.
+* Using your best judgment based on age, diagnosis, pre hospital admission ADL, and [[#Where to get data]] below, select the option that best reflects their ADL status
+* For ostomy care see [[ADL Toiletting]] and [[ADL Continence]]
+* For use of mechanical aids see [[ADL Transfering]]
 === Timeframe ===
-An ADL assessment is usually done within 24 hours of admission (done by allied health or nurses).
+The ADL assessment (done by allied health or nurses) we utilize is the patient's state of activity on first [[Service tmp entry]]. When possible, use an ADL assessment done within 24 hours after the admission to the ward
-The ADL assessment we utilize is the patient's state of activity on admission (not at home prior to admission). It takes into consideration acute medical issues that resulted in admission to the hospital.
-{{Discuss| To clarify this point, when does the  24 hour timeframe begin, from acceptance date/time or arrival date/time for patients admitted from ER? }}
+=== Low functioning ADL due to condition that is expected to be temporary ===
+If a patient is admitted with a diagnosis that is expected to improve to the point of higher functioning ADLs (and they possibly have improved already by the time collection happens), code the ADLs that are expected to be the long-term state.
+{{Ex|
+A patient is admitted with [[Diabetic ketoacidosis (DKA)]] and is expected to improve with treatment to the point where they can manage their activities of daily living (ADLs) independently. Code the ADLs based on their anticipated long-term state of independent functioning, even if they are still experiencing limitations at the time of data collection.
+}}
 === Directed Restrictions ===
-Directed restrictions on a patient's activities should not be assessed as requiring assistance. For example, if a pt is on bedrest restrictions, it does not mean that they are unable physically to get out of bed. If the patient would be able to perform the activity if allowed then they are to be assessed accordingly.
+Directed restrictions on a patient's activities should not be assessed as requiring assistance. Code these based on what the patient would actually be capable of doing if they were permitted.
+{{Ex|
+A patient comes in with a stroke. They can mobilize independently and go to the washroom. The patient is then ordered to be on bedrest after a procedure. If the patient would be able to perform the activity if allowed then they are to be assessed accordingly. So in this case they would would be coded as '''unassisted'''.
+}}
 === Where to get data ===
@@ Line 19: / Line 29: @@
 * Integrated progress notes
 * Risk assessment for falls form (if used)
+== Data Entry Instructions ==
+For every Medicine profile, enter the status into the ADL dropdown boxes in the [[Patient Viewer Tab ADL]] in [[CCMDB.accdb]].
 === Specific Activities collected ===
@@ Line 28: / Line 41: @@
 * [[ADL Continence]]
 * [[ADL Feeding]]
-== Scoring ==
-The field is driven by [[S_ADLOptions table]].
-Performance of each of the activities is evaluated as unassisted (0 points), minor assistance (3 points), or major assistance (6 points).
-'''Total ADL Score''' is the sum of points of all the six activities.
-ADL is also part of the [[ALERT Scale]].
 == Data Use ==
-* [[ALERT Scale Calculation]]
+* [[ADL Score]]
-* Reported quarterly
+* [[ALERT Scale]]
-** Average
-** Frequencies by Categories (e.g. 1-6, 7-12, 13-18, 19-24, 25-30, 31-36)
-=== in CCMDB.accdb ===
-In CCMDB the ADLs are stored as their full words rather than scores, e.g. "ADL_Bathing" might have a value of "unassisted". The values are entered via dropdown list, which is driven by the [[S_ADLOptions table]]. In that table there is a column "sorter" with numbers used to change the order the values appear in the dropdown list. The column is '''not''' a score and not used for anything beyond sorting.
 == References/Background ==
 The evaluation tool used for all Medicine patients is the Katz ADL.
 * S Katz et al. Studies of illness in the aged: the index of ADL. American Medical Association, 1963.
 * S Katz, SD Downs, HR Cash, RC Grotz. Index of daily living. ''The Gerontologist'' 1:20-301.